The authors describe a case of visceral leishmaniasis in an intravenous drug abuser, HIV seropositive patient. Visceral leishmaniasis was the first opportunist infection and diagnosis was based on smear from bone marrow. A treatment with N-methylglucamine and allopurinol was successful. The authors stress to take into account visceral leishmaniasis in HIV-infected patient in act resident or in past lived in endemic for Leishmania areas even in presence of atypical clinical features and propose to include visceral leishmaniasis as an opportunist infection in the IVC-2 group of clinical classification of HIV infection.